1396883732 NPI number — THE JOHN ENGLE CHRISTIAN COUNSELING CENTER

Table of content: (NPI 1396883732)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396883732 NPI number — THE JOHN ENGLE CHRISTIAN COUNSELING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE JOHN ENGLE CHRISTIAN COUNSELING CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396883732
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 LUDLOW ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45011-2922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-896-4357
Provider Business Mailing Address Fax Number:
513-896-1050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 LUDLOW ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45011-2922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-896-4357
Provider Business Practice Location Address Fax Number:
513-896-1050
Provider Enumeration Date:
02/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STEPHENSON
Authorized Official First Name:
ALICE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
513-896-4357

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  JO9288521 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: JOSW10284 . This is a "KRISTI JOHNSON MSW, LISW" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: HESW17111 . This is a "JERRY HEATHERLY MDIV LISW" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: OVSW19101 . This is a "LEANNE J. MYERS MSW, LISW" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com